Hälbig T D, Gruber D, Kopp U A, Schneider G-H, Trottenberg T, Kupsch A
Department of Neurology, Mount Sinai School of Medicine, One Gustave L Levy Place, Box 1137, New York, NY 10029, USA.
J Neurol Neurosurg Psychiatry. 2005 Dec;76(12):1713-6. doi: 10.1136/jnnp.2004.057992.
Bilateral deep brain stimulation (DBS) of the globus pallidus internus (GPi) alleviates symptoms in patients with dystonia but its effects on cognition, neuropsychiatric status, and quality of life have not been examined. This is a case series report of 15 consecutive patients with different forms of dystonia who underwent bilateral implantation of DBS electrodes in the GPi. The patients were evaluated preoperatively and after 3-12 months of DBS with tests of cognition (Mattis Dementia Rating Scale, Stroop Test, Trail Making Test, Phonemic and Category Word Fluency, Digit Span, Rey Auditory Verbal Learning Test, Tonic and Phasic Alertness), neuropsychiatric status (Beck Depression and Anxiety Inventories, Montgomery Asberg Depression Rating Scale, Snaith-Hamilton Pleasure Scale, Brief Psychiatric Rating Scale), quality of life, and motor functions. GPi DBS significantly improved dystonic symptoms, functional abilities, and quality of life allowing for a significant reduction of antidystonic medications. No deterioration was observed in cognitive scores and neuropsychiatric measures. The present case series report thus provides preliminary evidence for the safety of GPi DBS regarding cognitive and neuropsychiatric functions in patients with dystonia.
双侧苍白球内侧部（GPi）深部脑刺激（DBS）可缓解肌张力障碍患者的症状，但其对认知、神经精神状态和生活质量的影响尚未得到研究。这是一篇病例系列报告，连续纳入15例不同类型肌张力障碍患者，均接受了双侧GPi脑深部刺激电极植入术。术前及DBS治疗3 - 12个月后，对患者进行认知测试（马蒂斯痴呆评定量表、斯特鲁普测验、连线测验、语音和类别词汇流畅性、数字广度、雷伊听觉词语学习测验、紧张性和相位警觉性）、神经精神状态评估（贝克抑郁和焦虑量表、蒙哥马利-阿斯伯格抑郁评定量表、斯奈斯-汉密尔顿愉悦量表、简明精神病评定量表）、生活质量和运动功能评估。GPi-DBS显著改善了肌张力障碍症状、功能能力和生活质量，使抗肌张力障碍药物用量大幅减少。认知评分和神经精神指标未观察到恶化。因此，本病例系列报告为GPi-DBS在肌张力障碍患者认知和神经精神功能方面的安全性提供了初步证据。
